Amber
by DaenerysTargary3n
Summary: When Alex's little sister shows up in Grey Sloan Memorial's ER, everyone's lives are affected by the presence of the youngest Karev sibling. Set as an AU months after the season 9 finale.
1. Chapter 1

**Amber**

"_Friends are the siblings God never gave us."_

~ Mencius (372 – 289 BC)

"Incoming trauma fifteen minutes out," Owen Hunt bellowed as he hung up the phone to emergency dispatch, "young female involved in a head-on collision with a lorry, unconscious in the field, so get Shepherd down here!"

When Dr. Hunt called an incoming trauma, the entire ER seemed to receive an electric shock and sprang into life. Nurses swam around the already busy room, readying the kits that they would need for the patient that was about to cross the threshold of Grey Sloan Memorial. Interns were bleary eyed and exhausted from their long shifts but were still alert enough to perform the basic routines that they went through day after day and night after on their patients. Owen himself was draping himself in a trauma gown, going through what he had to do when the rig arrived.

The doors opened and a rush of paramedics rushed in with a gurney, chanting off the stats of the patient who still lay unconscious as she was wheeled into the ER. Matthew, Kepner's fiancé, was on duty tonight so Owen knew that the girl who could not have been older than nineteen was in the best shape she could have been in these circumstances.

Nicole pulled Owen off to one side as the patient was deposited in Trauma Room One and whispered in his ear, "Page Alex Karev, Owen."

"She's not a paediatric case; we don't need Karev down here. We've already paged Shepherd."

The female paramedic sighed, detesting giving news like this to her friends, "That's not why you'll be paging Alex," she said wistfully, pulling a card out of her pocket, "this is."

Owen looked at the ID card that she took out of her pocket and groaned as he recognised the surname of the young girl who was a freshman at Iowa State. Her name was Amber Violet Karev. He did not know much about the young paediatric fellow, but he was aware that Alex Karev came from a tough family background and was pretty much on his own in the world except for his fellow surgeons, whom he considered to be his family.

"Somebody page Alex Karev down here," he roared to no one in particular, before calling to April and the others in his team, "and let's do our best work people. This is Alex Karev's sister."

When Alex heard the Tannoy system say that he needed to be in the ER, he rushed down to Trauma Room One with his usual speed when an emergency came in, but when he recognised the charred, bloody face of his baby sister, he raced into the room.

"What happened? How? How is she here….like this?"

April Kepner saw the abject worry and fear that was painted across her colleague and friend's face and left the patient's bedside to soothe his anxieties as best she could, "Alex, Alex, calm down. She was in a car accident. A lorry hit her car. The driver of the other vehicle died instantly. I know it looks bad but Shepherd's been paged and though she is unconscious, she's doing okay."

"Well, where the hell is Shepherd! He should be here already!"

In typical Alex Karev form, he had lost his mind with worry for his family. April did not know the details of his upbringing but she imagined it must have been pretty rough to create this man who could not allow anyone to help him or to be a human when one of the few people he cared for was at risk.

"He's on his way. We're going to put her in the LODOX so we'll know everything we can in minutes, okay? Just breathe, Alex, she's going to be fine."

By the time Amber Karev was placed into the high-tech scanner, the entire hospital was abuzz with the gossip that Alex Karev, who was the mystery of the hospital to most of its staff, had a little sister who had just been admitted. Derek heard before he reached the ER and he was one of the fortunate (or not so much) few who was cognisant of the trials and tribulations that Alex and both his siblings had faced throughout their formative years, so he could not believe that Alex and his family were to be tested once more by the universe.

"What have we got?" Derek asked as he came on the scene.

Owen nodded at him, "Just coming up on the screen now. Wait for it."

Derek immediately sprang into action once he saw the results of the LODOX scan, "So, she's injured C5 and C6, though we can repair that in surgery. It's a relatively simple procedure for me. What is worrying is this."

The other three surgeons who were examining the full body scan noticed the intracranial injury that was the reason for her state of unconsciousness after the accident. She had a serious epidural hematoma, which required immediate surgery. They all knew that Shepherd, being the Medical Titan that he was, would be able to fix both injuries in one surgery, but Torres would have to be part of the surgical team to be on standby for the spinal injury and more critically, to repair her femur which had broken and was protruding through the muscle and skin tissue of her left leg.

Alex had tolerated enough of his colleagues standing about and not operating on his sister who was in bad condition, so he declared, "Right, so get her into the OR and I am scrubbing in."

The Chief of Surgery turned to him and shook his head, "Karev, you know I cannot let you be in that OR. You're a relative in this case, not a surgeon."

"Screw you, Hunt," Alex shot off, "she's my little sister and I am not leaving her, not this time, not ever again. It's probably my fault she is in this mess. She would not have been in this damn city if it wasn't for me. She's got no one here. The only people she knows are in Iowa except for the one member of her family who's still standing – me – Alexander Michael Karev, paediatric surgical fellow, Grey Sloan Memorial Hospital."

Derek and Owen were impressed by Karev's outburst and Owen patted him on the back and told him to get scrubbed but warned him that if he opened his mouth once, he would be kicked out of Shepherd's OR. With a pained looked of gratitude on his face, he stalked after Shepherd and the comatose body of his favourite sibling.

The world was spinning for the overwhelmed brother who just watched yet another family member be carted off before him. He could not believe that after everything he and his two siblings had endured from their parents, it had all come to this: one brother in a psychiatric institution, a sister about to have major, life-altering surgery and him, the oldest of them all, who was supposed to protect and defend them, living as far away from his ancestral home as he was able.

Of course, Alex did speak up during the operation when Amber was asystolic for what seemed like a lifetime and was consequently sentenced to observe from the gallery by Callie once his sister's heart restarted. Once he was safely away from the operating table and sitting above the OR watching as Derek Shepherd relieved the bleeding in Amber's brain, his friends joined him.

Meredith knew Alex, really knew him. She had been the first in their close-knit group to see that Alex Karev was more than the abrupt, rude and cocky frat boy that he pretended to be. As the Queen of Defence Mechanisms, she recognised a kindred spirit in Alex, someone who also appeared dark and twisty at times to avoid the pain and hurt that he had faced in his past but kept chasing him no matter where he fled. It grieved her truly to watch him go through yet another hardship in his life, but she knew that he would emerge the other side a stronger and better man because that is what Alex Karev did. He kept punching back at life, daring it to find something that could take him down once and for all.

Cristina could not claim to be close to her fellow surgeon but since they had moved in together, the degrees of distance between them had lessened. She could now own to being one of his best friends, especially since she was now his emergency contact. She truly respected and appreciated that from Alex, even though the entire conversation about power of attorney had been in jest, he didn't have to say that he would name her as his proxy. Alex and her had a lot in common, she had discovered over the years, they were both hardcore, she for cardio, him for paeds, both of them had experienced failed marriages and they both were godparents to little Derek Bailey Shepherd.

"How are you doing, Alex?" Meredith eventually asked, hesitant to hold his hand.

He shrugged in response, "Okay, I guess. I mean, Shepherd and Torres are great surgeons and she's doing fine now, so she'll make it out of this."

"Hey, is it true?" Arizona asked as she entered the gallery of OR Two.

Cristina nodded and Meredith took Alex's hand as he winced at his mentor's question.

"Karev, is she okay?"

Alex looked at Arizona, whom he considered to be one of his greatest friends and allies in the hospital, "Yeah, she'll be fine, Robbins. Don't worry your little blonde head about it. Go back to the paeds ward and the little humans. It does no one any good for four surgeons to be sitting in here waiting for Torres and Shepherd to finish operating on my sister."

That, right there, was one of the main reasons why Arizona adored Alex, not in a romantic way at all, but definitely in a family way. He was like her little brother and her go-to-guy when she needed something doing on the ward or someone to talk to about her personal life. She worried about him…constantly. She had told him that she didn't want to worry about her protégée but she couldn't help it. He just was such a mess and very few people had his back and she knew that he had existed like that for so long that he didn't expect anyone to really support him or be on his team. That's what she was, she wasn't his family she was his team.

"I'm sticking around, Karev," Arizona replied, "and don't bring my department into this, because I run my paediatric ward damn well."

Derek finished cauterising the bleed in his patient's brain and was convinced that she would fully recover from the procedure and her accident. He looked up at the occupied gallery and nodded to the waiting brother, signalling that his and Callie's work was done and that Amber would be wheeled into post-op any minute now.

Alex's companions clapped him on the back, all sharing in the relief that he felt that the surgeons below him were closing up. He, in contrast, remained stoic and still, unable to process what had just happened until suddenly he got up and walked out of the gallery, leaving his colleagues behind, all unsure as to what just happened.

He sprinted as fast as he could to the men's room where he locked himself in a cubicle and poured his guts out into the bowl. He felt empty. Not Meredith Grey after a night of tequila and throwing up empty, but Meredith Grey after social services took Zola away empty. It brought foreign tears to his eyes, eyes that almost always refused to weep over anything and everything. The thought of his little sister in emergency surgery made his stomach churn but he could resolve that with a strong antacid, however, to solve the issue of his sister having to drive a long way to Washington, he had to talk to Cristina and Jo, who had utterly slipped his mind since he saw his sister on a gurney.

Yang did not know why she had been paged to a conference room on the surgical floor and she was even more confused when she fell into step with Alex's intern other half. Both women looked at each other as they headed towards the same destination, both clueless.

"Dr. Yang, did Alex – I mean, Dr. Karev – page you?"

Cristina looked at her, "Yes. Do you know why Evil Spawn has had the two of us paged?"

She shook her head. She had been in the locker room with all the other interns, preparing to go home for the day when her pager went off. The entire hospital had heard that Alex's sister had been involved in a car accident, but she had not had the opportunity to find him and knew that he would be freaking out but expected to see him at home when one of his friends would force him to take off.

"Alex? Baby, you okay?" Jo asked tentatively as she went into the dark conference room, trying to avoid fixtures.

Cristina, instead of blindly fumbling around in the pitch black room, stroked the wall with her hand searching for the light switch. When she found it, both women saw the tearstained, wan face of Alex as he sat at the head of the table, holding his heavy head in his tired hands.

"Alex?" Jo asked, even more alarmed than she had been before the conference room was lit. A lot of things made her boyfriend angry and lash out at people, but very few things had the ability to turn him into a catatonic, weepy guy.

She hurried to his side and sat beside him, doing what she hadn't been able to do for him earlier in the day and rubbed his back soothingly. Once she had him in his arms, he crumbled. He could not stop the flood of emotions that he had pent up inside him for years from releasing and showing Cristina and Jo that he struggled with his childhood issues.

"Alex, how can we help?" Yang inquired, ever the pragmatist, choosing to leave the sentimental crap to Wilson.

The sobbing doctor finally, after a few minutes' effort, managed to pull himself together and hoarsely uttered, "I need Amber to move into the house, Cristina, for good. I can't send her back to Iowa. Do you mind?"

If the person in need had been anyone else, Yang knew that Alex would have merely taken them in using his ownership of the house as an excuse not to run it by his housemate, but Cristina respected the man for just giving her the heads-up that Amber would be taking up residence. He knew that she would not object but had phrased his decision as a question out of friendship, but she barely registered it.

"Of course she can."

"Thanks."


	2. Chapter 2

"_Don't wait for the last judgement – it takes place every day."_

~ Albert Camus (1913 – 1960)

All Alex could do was sit and wait, all he wanted to do was sit and wait for Amber to wake up and smile at him. When they were growing up he adored her smile. He was a thug and a jerk to everyone, be they boy or girl, everyone except his baby sister, who thought the world revolved around her eldest brother. No one got past him to even ask Amber to lend a pencil, let alone go out on a date or go to the movies. He made sure she was alright…always, so how had he managed to let her wind up in the ICU?

Mer and Jo had been his rocks over the past few days while Amber succumbed to a post-operative coma. Mer was his best friend and the one who knew him better than anyone – even Jo – and she had brought Bailey by whenever she could and the three of them had just watched as Amber breathed and existed. Jo had been keeping him company when Meredith had to go home but he did not want Jo knowing so much about him so soon into their relationship. He knew she had the same sort of past as he did but she never had dependants. He did.

Cristina had been readying the house and making sure that Amber had everything she could want for in the room that she was preparing. She even spent a small portion of her plane crash award on refurbishing the house so that Amber didn't think that her brother, the successful one in their family, lived in a house that was falling apart and still beaten from the storm.

"Hey, Alex," Mer's voice sang through the sterile air, "how's she doing tonight?"

Alex looked away from Amber's pale face, "Same as earlier. Her BP is elevated but that's to be expected. I know she's going to wake up any minute and then after that, I can take her home and keep her safe."

Meredith sighed as she pushed the stroller with her sleeping, infant son into the room and pulled up a chair by her friend. She just examined his expression for the tell-tale signs that the 'Old Alex' was making an appearance, but saw only grief, guilt, sadness and devastating longing for the only remaining sane member of his family to regain consciousness.

"I have a feeling that she will," she pronounced optimistically, "after all she wouldn't disobey her older brother, would she?"

Alex let out a guttural chuckle but stopped when another sound, a sound that came from neither Meredith nor Bailey nor him.

"I love the idiot too much to not do what I'm told." Amber said hoarsely, but with open eyes and smiling lips.

In the moment following Amber's return to the land of the living, Alex completely decomposed into a shell of a man as he spluttered and coughed and fell to the floor reaching for his sister's hand.

"You bitch!" Alex exclaimed, much to Meredith's horror.

Amber laughed, "Sorry, bro, guess I worried you a bit there, huh?"

Alex grinned his wide, boyish grin at her, "You sure did. How about never doing that again…_ever_?"

Amber winced as he said the last word and all she could do was nod.

Meredith quit the room and went to fetch a nurse before coming back, apologising to Amber, to perform a check-up just to make sure she had woken up because of something good, not something bad.

"Hello, Amber," she said in her doctor voice, "I'm Dr. Grey, but you can definitely call me Meredith for all I've heard about you from your brother. How are you feeling?"

"I'm feeling fine, a little sore…everywhere. So, do you know Alex well?"

Alex and Meredith shared a friendly, knowing glance, before Meredith finished her exam and went to the stroller and gently lifted Bailey out and handed him to Alex, who instantly started rocking back and forth, making sure that Bailey never stirred.

"Well, he is my kid's godfather, so yeah, I know him well and love him too."

Amber's eyes welled up at the sight of Alex, big, brash Alex, holding a baby and being utterly at ease with his precious cargo. It reminded her of how he used to hold her when their mom went off her meds and their dad kicked off, drunk on whatever his poison of choice was that night. She was so young when it all happened and Alex could not bear to see her cry or cringe in fear, worried that the door would cave in and their dad would come in looking for her or Aaron that he used to pull her up onto his lap and hold her until she cried herself to sleep or until the ruckus let up, whichever came first.

"You look good with that kid."

Alex smiled, "I should hope so, seeing as it's my job to be good with kids, sis."

"Huh?"

"I'm a paediatric surgeon, Amber. Every day, my job is to help sick kids and cut 'em open."

Amber laughed, "But that's great, Alex, you're doing such great things every day of your life. I'm proud of you."

"Ammy, why are you here?" He blurted out, unable to stand the constant compliments.

She flinched at his abruptness, "I couldn't be at home anymore, Alex. Mom never takes her meds. I go to see Aaron sometimes but he can barely think past his anti-psychotics and now, you're all I've got. You're all I've got, Alex and I want to be here…with you."

Alex passed the baby back to his mother so that he could sit on the bed next to Amber and take her into his arms and hold her as she wept. He had done the same when he had left Iowa and no one had been there to be with him as he felt the guilt and missed home and his family, but he could – and would – support Amber.

"You can stay, Amber. My friend has been fixing up my house just for you so you can stay, okay? Everything's going to be okay, now, sweet girl."

Meredith just stood back and watched as the siblings got reacquainted and Alex promised his sister everything he had. She understood the ties that bind between family members, but she worried for Alex, as she – and so many at Grey + Sloan – did constantly. He had a past of getting too invested in his relationships, which then let him down harshly. She did not want to see that happen to him again, he didn't deserve it, not after everything he endured from Rebecca Pope, Izzie, his brother coming back and his entire past. It plagued her mind that Alex was going to face so many more trials and tribulations in the coming months with his sister, whom she could see adored her brother and relied upon him and needed him so badly that she just upped and left, but she prayed (even though she wasn't praying to anybody in particular) that her friend would not be thrown back into that turmoil because of his sister's arrival in Washington.

She felt an unexpected tap on her shoulder and turned around to come face-to-face with Wilson, "Hey Wilson, I think they need to be left alone for a little while. You should come back later and I'm going now too."

Jo saw the intense way in which both Karevs were hugging the other and knew that she could meet Amber any time but Alex needed this time to remember his sister and what she truly meant to him. She had to right to impose on such a moment. All she could do was wish that she had family to have moments like that with.

She nodded at Meredith and walked away from the ICU room with her. She moved to get her cell from her white coat pocket to call Cristina to let her know that Amber had woken up at last and that she would (hopefully!) be coming home any day now.


End file.
